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Indiana rates for HCPCS C9765

Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s), when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,386.00 / $4,846.00 / $14,063.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,030.00 / $1,386.00 / $55,931.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,575.00 / $24,214.00 / $47,628.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89,999.10 / $89,999.10 / $89,999.10
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52,499.48 / $65,624.34 / $89,999.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,748.43 / $16,748.43 / $16,748.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,937.73 / $9,937.73 / $9,937.73
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,526.00 / $14,061.00 / $19,962.00